Yet American physicians are becoming increasingly aware of the benefits of ESD. Simplification of technique, modification of tools and materials, and improved availability of training opportunities are essential in order to accelerate the adoption of ESD in the United States. Index 321 “
“Charles J. Lightdale Tonya Kaltenbach and Roy Soetikno Matthew AZD5363 D. Rutter Patients with inflammatory bowel disease

colitis have an increased risk of developing colorectal cancer compared with the general population. Colonoscopic surveillance remains challenging because the cancer precursor (dysplasia) can have a varied and subtle endoscopic appearance. Although historically the dysplasia was often considered endoscopically invisible, today with advanced endoscopic see more understanding, technique, and imaging, it is almost always visible. The frequency of different dysplasia morphologies and true clinical significance of such lesions are difficult to determine from retrospective series, many of which were performed prior to the current endoscopic era. Silvia Sanduleanu and Matthew D. Rutter Interval colorectal cancers (CRCs) may account for approximately one half of

all CRCs identified during IBD surveillance. The etiology of interval CRCs is multifactorial, with procedural factors likely to play a major role. Molecular events promoted by inflamed mucosa may

augment the cancer risk and perhaps explain some interval CRCs. This article reviews key studies relating to CRC risk in the patient with IBD, paying particular attention to the occurrence of interval CRCs. The most common factors implicated in the etiology of interval CRCs, in particular missed, incompletely resected lesions, the adherence to recommended surveillance intervals and biologic pathways associated with a faster progression to cancer are examined. Basic concepts for quality and effectiveness of colonoscopic surveillance in IBD are summarized. Rachel Zarrow, Alison Zarrow, and Hilary Zarrow This article advocates the use of chromoendoscopy to detect flat lesions over the use of colonoscopy alone. The authors illustrate their point Aspartate by telling the story of their father, who died of colon cancer despite following the gold standard inflammatory bowel disease protocol. Christopher G. Chapman and David T. Rubin It has been proposed that effective disease control through abrogation of inflammation in IBD may also reduce CRC risk in these individual patients. This article summarizes the potential for medical therapy to reduce the risk of CRC via primary and secondary prevention, and offers practical ways in which a goal of mucosal improvement or healing may be incorporated into clinical practice.